Tag Archives: False Claims Act
HEALTHCARE WITH A SIDE OF HAIRCARE: IMPROPER INCENTIVES TO MEDICARE PATIENTS
Offering free gifts with purchase is not a new marketing concept. Many businesses use it as an effective tool for customer retention and soliciting new customers. When the customers are paying with government funds, however, free gifts can be a big no-no. Especially when the free gifts offered to Medicare beneficiaries have no relation… Read More »
Medicare Advantage Audit Shows $197 Million in Over-Payments
In April 2021, the Department of Health and Human Services, Office of Inspector General (HHS-OIG) released a report regarding a Medicare Advantage Compliance Audit of one of the country’s major Medicare Advantage Organizations, Humana, Inc. The audit covered only one year, 2015, and one particular contract. The audit selected a random sampling of 200… Read More »
Government Issues Preliminary Report on Coronavirus Relief Fraud
On September 1, 2020, the Congressional Select Subcommittee on the Coronavirus Crisis released a preliminary analysis of potential waste, fraud and abuse issues in the Paycheck Protection Program (PPP), which was implemented as part of the massive Coronavirus Aid, Relief and Economic Security (CARES) Act. Under the PPP Program, the federal government provided more… Read More »
CARES Act Fraud – the Paycheck Protection Program
On March 27, 2020, Congress passed the Coronavirus Aid, Relief and Economic Security Act of 2020, also known as the CARES Act. In total, the CARES Act will provide approximately $2 trillion in economic aid in the wake of the Coronavirus (COVID19). This is the largest economic aid package in the history of the… Read More »
Frequently Asked Questions about Whistleblower Claims
The federal government, along with some states, have enacted important tools that help expose corruption and fraud related to contracted services or product purchases by governmental agencies. The False Claims Act is a federal law that imposes liability on companies and individuals who defraud the government. It also allows someone with the knowledge of… Read More »
Qui Tam Defective Bulletproof Vests Case Settles for $66 Million
A settlement was recently announced in a long-running qui tam case brought by whistleblower Aaron Westrick, Ph.D., who alleged Toyobo Co. Ltd. of Japan and its American subsidiary, Toyobo USA Inc., (collectively, Toyobo), sold Zylon fiber that was defective. This fiber was used for bulletproof vests purchased by the United States government for federal,… Read More »
What is a Reverse False Claim?
Most qui tam whistleblower lawsuits under the False Claims Act involve a Defendant who has made a fraudulent “claim” for money upon the government. For example, when a hospital sends a bill to Medicare for a medical procedure that was never performed, the hospital has made a “claim” for money upon the government. If… Read More »
False Claims Act: Top Health Care Recoveries for Fiscal Year 2017
There’s no denying that health care fraud accounts for a large percentage of the claims that qualify under the Federal False Claims Act (FCA). According to the Justice Department, of the more than $3.7 billion in settlements and judgments recovered in fiscal year 2017, $2.4 billion of them involved the health care industry. Claims… Read More »
Justice Department Recovers over $3.7 Billion in False Claims Act Cases in the 2017 Fiscal Year
The United States Department of Justice recently released statistics from the 2017 fiscal year, which includes more than $3.7 billion in settlements and judgments from civil cases involving fraud and false claims. Total recoveries since the False Claims Act (FCA) was strengthened in 1986 now top more than $56 billion. Types of Recoveries Of… Read More »
Qui Tam Litigation: What is the False Claims Act?
We talk about qui tam, or whistleblower litigation, but what is the False Claims Act (FCA) that brings rise to this type of litigation. Qui Tam Defined The word qui tam is Latin and translates to “who as well”, and references lawsuits that are brought on behalf of the plaintiff and the government. These… Read More »